Prevalence of the metabolic syndrome in a rural population in Ghana

Abstract Background The Metabolic syndrome (MS) which is a constellation of cardiometabolic risk factors including dyslipidaemia, hypertension, hyperglycaemia, central obesity, and endothelial dysfunction was hitherto relatively uncommon among Africans south of the Sahara. This study seeks to determine the prevalence of MS, its components and risk factors among a rural population in Ghana based on two popular international algorithms. Methods This was a cross-sectional survey of a rural population in Ghana conducted between November and December, 2007. Two hundred and twenty-eight (228) settler farmers, families and staff associated with the GOPDC Ltd, between the ages of 35 and 64 years, were randomly selected for the study; pregnant women were excluded. The prevalence of MS was estimated using the IDF and ATPIII criteria. Results The final subject pool included 102 males, and 104 females. The mean age of all subjects was 44.4 ± 6.9 years. The overall prevalence of MS by the IDF and ATPIII criteria were 35.9% and 15.0%, respectively, but there was an alarming female preponderance by both criteria {IDF: males = 15.7%, females =55.8%; ATPIII: males = 5.9%, females = 24.0%; sex differences p<0.001 for both criteria}. The most important determinants for IDF-defined MS were central obesity (55.3%), low High Density Lipoprotein (42.7%) and high Blood Pressure (39.5%). Conclusion The triad of central obesity, high blood pressure and low HDL were most responsible for the syndrome in this rural population.http://deepblue.lib.umich.edu/bitstream/2027.42/112461/1/12902_2012_Article_148.pd

Processes to manage analyses and publications in a phase III multicenter randomized clinical trial

Background: The timely publication of findings in peer-reviewed journals is a primary goal of clinical research. In clinical trials, the processes leading to publication can be complex from choice and prioritization of analytic topics through to journal submission and revisions. As little literature exists on the publication process for multicenter trials, we describe the development, implementation, and effectiveness of such a process in a multicenter trial. Methods: The Hepatitis C Antiviral Long-Term Treatment against Cirrhosis (HALT-C) trial included a data coordinating center (DCC) and clinical centers that recruited and followed more than 1,000 patients. Publication guidelines were approved by the steering committee, and the publications committee monitored the publication process from selection of topics to publication. Results: A total of 73 manuscripts were published in 23 peer-reviewed journals. When manuscripts were closely tracked, the median time for analyses and drafting of manuscripts was 8 months. The median time for data analyses was 5 months and the median time for manuscript drafting was 3 months. The median time for publications committee review, submission, and journal acceptance was 7 months, and the median time from analytic start to journal acceptance was 18 months. Conclusions: Effective publication guidelines must be comprehensive, implemented early in a trial, and require active management by study investigators. Successful collaboration, such as in the HALT-C trial, can serve as a model for others involved in multidisciplinary and multicenter research programs. Trial registration The HALT-C Trial was registered with clinicaltrials.gov (NCT00006164)

Technologies and Methods Used at the Laboratory for Atmospheric and Space Physics (LASP) to Serve Solar Irradiance Data

The Laboratory for Atmospheric and Space Physics (LASP) at the University of Colorado in Boulder, USA operates the Solar Radiation and Climate Experiment (SORCE) NASA mission, as well as several other NASA spacecraft and instruments. Dozens of Solar Irradiance data sets are produced, managed, and disseminated to the science community. Data are made freely available to the scientific immediately after they are produced using a variety of data access interfaces, including the LASP Interactive Solar Irradiance Datacenter (LISIRD), which provides centralized access to a variety of solar irradiance data sets using both interactive and scriptable/programmatic methods. This poster highlights the key technological elements used for the NASA SORCE mission ground system to produce, manage, and disseminate data to the scientific community and facilitate long-term data stewardship. The poster presentation will convey designs, technological elements, practices and procedures, and software management processes used for SORCE and their relationship to data quality and data management standards, interoperability, NASA data policy, and community expectations

Psycho-Ecological Systems Model: A Systems Approach to Planning and Gauging the Community Impact of Community-Engaged Scholarship

This article presents the Psycho-Ecological Systems Model (PESM) – an integrative conceptual model rooted in General Systems Theory (GST). PESM was developed to inform and guide the development, implementation, and evaluation of transdisciplinary (and multilevel) community-engaged scholarship (e.g., a participatory community action research project undertaken by faculty that involves graduate and/or undergraduate students as service-learning research assistants). To set the stage, the first section critiques past conceptual models. Following a description of GST, the second section provides a comprehensive description of PESM, which represents an integration of three conceptual developments: the ecological systems model (Bronfenbrenner, 1979), the biopsychosocial model (Kiesler, 2000), and the principle of reciprocal determinism (Bandura, 1978). In the third section, we discuss implications of PESM for community-based research. A greater emphasis on the development of integrative conceptual frameworks may increase the likelihood that community-based research projects will: (a) address complex questions; (b) develop and implement efficacious (and sustainable) transdisciplinary (and multilevel) projects; (c) assess constructs at multiple levels using a blend of quantitative and qualitative approaches; and (d) utilize multiple research designs and methods to systematically examine hypotheses regarding a project’s influence on outcome variables and process variables

Pathways to integrate Indigenous and local knowledge in ocean governance processes: Lessons from the Algoa Bay Project, South Africa

The Introduction of this paper argues that current coastal and ocean management approaches like marine spatial planning (MSP) often do not adequately acknowledge and integrate Indigenous and Local Knowledge (ILK). This is problematic because how humans value and perceive coastal and marine resources is integrally linked to how they use and manage these resources, especially in adapting to social-ecological change. Coastal and marine resources are situated within complex social-ecological systems that are culturally, economically, historically and politically embedded. Therefore, management approaches have to integrate transdisciplinary and contextual perspectives in order to be relevant, sustainable and adaptive. Following extensive research in Algoa Bay, South Africa this article highlights several pathways to bridge the gap between existing ILK and current coastal and ocean management approaches. The Methods section discusses how the authors worked in tandem with a bottom-up (engaging with Indigenous and local coastal and marine resource users) and top-down (engaging with coastal governance authorities and practitioners) approach. In order to answer the primary research question “How can ILK be integrated into area-based ocean management like MSP”? the authors employed arts-based participatory methods as well as in-depth interviews and workshops with coastal governance authorities and practitioners over several months. This work then culminated in a one-day multi-stakeholder workshop which brought both ILK holders and coastal authorities and practitioners together to collaboratively identify pathways to integrate this knowledge into coastal and ocean management. In the Results and Discussion section the authors present and discuss five co-identified pathways to integrate ILK in coastal and ocean management which include: adopting contextual approaches to coastal and ocean management; increasing transparency and two-way communication between coastal authorities and users; increasing access to relevant and useable information; reviewing and amending relevant MSP legislation towards a stronger connection between MSP and Indigenous knowledge legislation; as well as amending legislation pertaining to access to coastal and marine areas. In the Conclusion it is argued that ILK coastal communities want to be meaningfully included in how their coastline and ocean resources are managed and also seek increased access to coastal areas. By highlighting pathways to include ILK and the knowledge holders themselves, this paper seeks to contribute to improved protection and sustainable management of marine resource use

Developing a typology for peer education and peer support delivered by prisoners

Peer interventions delivered for prisoners by prisoners offer a means to improve health and reduce risk factors for this population. The variety of peer programs poses challenges for synthesizing evidence. This paper presents a typology developed as part of a systematic review of peer interventions in prison settings. Peer interventions are grouped into four modes: peer education, peer support, peer mentoring and bridging roles, with the addition of a number of specific interventions identified through the review process. The paper discusses the different modes of peer delivery with reference to a wider health promotion literature on the value of social influence and support. In conclusion, the typology offers a framework for developing the evidence base across a diverse field of practice in correctional health care

Constraining the Composition of the Subcontinental Lithospheric Mantle Beneath the East African Rift: FTIR Analysis of Water in Spinel Peridotite Mantle Xenoliths

The East African Rift System was initiated by the impingement of the Afar mantle plume on the base of the non-cratonic continental lithosphere (assembled during the Pan-African Orogeny), producing over 300,000 kmof continental flood basalts approx.30 Ma ago. The contribution of the subcontinental lithospheric mantle (SCLM) to this voluminous period of volcanism is implied based on basaltic geochemical and isotopic data. However, the role of percolating melts on the SCLM composition is less clear. Metasomatism is capable of hybridizing or overprinting the geochemical signature of the SCLM. In addition, models suggest that adding fluids to lithospheric mantle affects its stability. We investigated the nature of the SCLM using Fourier transform infrared spectrometry (FTIR) to measure water content in mantle xenoliths entrained in young (1 Ma) basaltic lavas from the Ethiopian volcanic province. The mantle xenoliths consist dominantly of spinel lherzolites and are composed of nominally anhydrous minerals, which can contain trace water as H in mineral defects. Eleven mantle xenoliths come from the Injibara-Gojam region and two from the Mega-Sidamo region. Water abundances of olivines in six samples are 1-5ppm H2O while the rest are below the limit of detection (<0.5 ppm H2O); orthopyroxene and clinopyroxene contain 80-238 and 111-340 ppm wt H2O, respectively. Two xenoliths have higher water contents - a websterite (470 ppm) and dunite (229 ppm), consistent with involvement of ascending melts. The low water content of the upper SCLM beneath Ethiopia is as dry as the oceanic mantle except for small domains represented by percolating melts. Consequently, rifting of the East African lithosphere may not have been facilitated by a hydrated upper mantle

Excess mortality in patients with advanced chronic hepatitis C treated with long-term peginterferon

Chronic hepatitis C virus infection can cause chronic liver disease, cirrhosis and liver cancer. The Hepatitis C Antiviral Long-term Treatment against Cirrhosis (HALT-C) Trial was a prospective, randomized controlled study of long-term, low-dose peginterferon therapy in patients with advanced chronic hepatitis C who failed to respond to a previous course of optimal antiviral therapy. The aim of this follow-up analysis is to describe the frequency and causes of death among this cohort of patients. Deaths occurring during and after the HALT-C Trial were reviewed by a committee of investigators to determine the cause of death and to categorize each death as liver- or nonliver-related and as related or not to complications of peginterferon. Rates of liver transplantation were also assessed. Over a median of 5.7 years, 122 deaths occurred among 1,050 randomized patients (12%), of which 76 were considered liver-related (62%) and 46 nonliver-related (38%); 74 patients (7%) underwent liver transplantation. At 7 years the cumulative mortality rate was higher in the treatment compared to the control group (20% versus 15%, P = 0.049); the primary difference in mortality was in patients in the fibrosis compared to the cirrhosis stratum (14% versus 7%, P = 0.01); comparable differences were observed when liver transplantation was included. Excess mortality, emerging after 3 years of treatment, was related largely to nonliver-related death; liver-related mortality was similar in the treatment and control groups. No specific cause of death accounted for the excess mortality and only one death was suspected to be a direct complication of peginterferon. Conclusion: Long-term maintenance peginterferon in patients with advanced chronic hepatitis C is associated with an excess overall mortality, which was primarily due to nonliver-related causes among patients with bridging fibrosis. (H EPATOLOGY 2011;)Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/83750/1/24169_ftp.pd

A systematic review of the effectiveness and cost-effectiveness of peer education and peer support in prisons.

BACKGROUND: Prisoners experience significantly worse health than the general population. This review examines the effectiveness and cost-effectiveness of peer interventions in prison settings. METHODS: A mixed methods systematic review of effectiveness and cost-effectiveness studies, including qualitative and quantitative synthesis was conducted. In addition to grey literature identified and searches of websites, nineteen electronic databases were searched from 1985 to 2012. Study selection criteria were: Population: Prisoners resident in adult prisons and children resident in Young Offender Institutions (YOIs). INTERVENTION: Peer-based interventions Comparators: Review questions 3 and 4 compared peer and professionally led approaches. OUTCOMES: Prisoner health or determinants of health; organisational/ process outcomes; views of prison populations. STUDY DESIGNS: Quantitative, qualitative and mixed method evaluations. RESULTS: Fifty-seven studies were included in the effectiveness review and one study in the cost-effectiveness review; most were of poor methodological quality. Evidence suggested that peer education interventions are effective at reducing risky behaviours, and that peer support services are acceptable within the prison environment and have a positive effect on recipients, practically or emotionally. Consistent evidence from many, predominantly qualitative, studies, suggested that being a peer deliverer was associated with positive effects. There was little evidence on cost-effectiveness of peer-based interventions. CONCLUSIONS: There is consistent evidence from a large number of studies that being a peer worker is associated with positive health; peer support services are also an acceptable source of help within the prison environment and can have a positive effect on recipients. Research into cost-effectiveness is sparse. SYSTEMATIC REVIEW REGISTRATION: PROSPERO ref: CRD42012002349